Evidence map›Paper›PMID 26503879›Full record

ArticleCulture, health & sexuality2016

Gendered power dynamics and women's negotiation of family planning in a high HIV prevalence setting: a qualitative study of couples in western Kenya.

Elizabeth K Harrington, Shari Dworkin, Mellissa Withers, Maricianah Onono, Zachary Kwena, Sara J Newmann

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Culture, health & sexuality, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 2 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Elizabeth K Harringtona Department of Obstetrics and Gynecology , Oregon Health and Science University , Portland , USA.
Shari Dworkinb Department of Social and Behavioral Sciences , University of California , San Francisco , USA.
Mellissa Withersc Institute for Global Health , University of Southern California Keck School of Medicine , Los Angeles , USA.
Maricianah Ononod Research, Care, and Training Program, Center for Microbiology Research , Kenya Medical Research Institute , Kisumu , Kenya.
Zachary Kwenad Research, Care, and Training Program, Center for Microbiology Research , Kenya Medical Research Institute , Kisumu , Kenya.
Sara J Newmanne Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital , University of California , San Francisco , USA.

Funding

Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEVEN Grant DEEKS · 1988 to 2026
$93.6M
Clinical and Transtional Science InstituteKL2TR000143 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$11.9M
NCATS NIH HHS KL2 TR000143NCATS NIH HHS KL2TR000143NIAID NIH HHS P30 AI027763NIAID NIH HHS P30 AI27763
6 · The paper itself

Abstract

In sub-Saharan Africa, high burdens of HIV and unmet need for contraception often coexist. Research emphasises the need to engage men and couples in reproductive health, yet couples' negotiations around fertility and family planning in the context of HIV have been sparsely studied. This study examined the gendered power dynamics that frame women's and couples' negotiations of contraceptive use in western Kenya. We conducted 76 in-depth interviews with 38 couples, of whom 22 couples were concordant HIV-positive. Qualitative data were analysed using a grounded theory approach. Direct communication around contraception with men was often challenging due to perceived or expressed male resistance. A substantial minority of women avoided male reproductive decision-making authority through covert contraceptive use, with concern for severe consequences when contraceptive use was discovered. Many men assumed that family planning use signified female promiscuity and that infidelity motivated covert use. Men were more willing to use condoms to avoid HIV re-infection or on the recommendation of HIV care providers, which allowed some women leverage to insist on condom use. Our findings highlight the tension between male dominated reproductive decision making and women's agency and point to the need for gender transformative approaches seeking to challenge masculinities that negatively impact health.

Indexed as

Contraception BehaviorDecision MakingPower, PsychologicalSpousesAdolescentAdultFamily Planning ServicesFemaleGrounded TheoryHIV InfectionsHumansKenyaMaleMiddle AgedPrevalenceQualitative ResearchgenderHIV/AIDSKenyamasculinityreproductive health

Identifiers

PMID26503879
PMCPMC5726384

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.